Colon to Rectum
Aliment Pharmacol Ther. 2022;56(9):1361–9
Ustekinumab during pregnancy in patients with inflammatory bowel disease: A prospective multicenter cohort study
Background: Women with inflammatory bowel diseases (IBD) often receive biologics to maintain remission during pregnancy.
Aims: To assess maternal and neonatal outcomes in patients with IBD treated with ustekinumab (UST) during pregnancy.
Methods: In a multicenter, prospective cohort study, the authors recruited women with IBD treated with UST during pregnancy between 2019 and 2021. Outcomes were compared among patients treated with UST, anti-tumor necrosis factor alpha (anti-TNF), and non-UST, non-anti-TNF therapies. UST-treated patients were matched 1:2 to controls according to age, body mass index and parity. Newborns were followed up to 12 months.
Results: 129 pregnant patients were recruited: UST 27; anti-TNF 52; non-UST, non-anti-TNF 50 (thiopurine or mesalazine 30, no therapy 20); Crohn’s disease 25 (96.9%). Overall, pregnancy, neonatal and newborn outcomes were satisfactory, with no significant differences among patients treated with UST, anti-TNF and non-UST, non-anti-TNF agents for obstetrical maternal complications (UST 3 [11.5%], anti-TNF 12 [23.1%], non-UST, non-anti-TNF 4 [8.2%], p = 0.095), pre-term delivery (1 [4.3%], 9 [18.4%], 4 [5.7%], p = 0.133), low birth weight (1 [4.2%], 5 [10.2%], 4 [8.3%], p = 0.679), or first year newborn hospitalization (2 [9.1%], 4 [8.2%], 3 [6.1%], p = 0.885).
Conclusion: Pregnant patients with inflammatory bowel disease (IBD) treated with ustekinumab (UST) demonstrated favorable pregnancy and neonatal outcomes that were comparable with those in patients treated with anti-TNF or other therapy. Data are reassuring for patients with IBD and their physicians when considering UST during pregnancy.